Additional Information Form Login

If you received a notice about your claim for a pro rata share of the Out-of-Pocket Reimbursement Fund and you would like to provide additional supporting documentation for your claim, or if you would like to direct your Settlement Payment to a family member, please login with the Unique ID and PIN printed on the letter that was sent to you. If you lost your Unique ID and PIN, you should contact the Claims Administrator at info@Anthem-RTC-Criteria-Settlement.com to request a Unique ID and PIN.

Any supporting documentation, including documents supporting a change in the Payee, must be submitted by October 9, 2026.